Introduction

After diminished performance in March, the PAI and the S&P 500 both rebounded in April with 4.91% and 10.42% month-over-month (MoM) gains respectively. Year-to-date (YTD), the PAI has increased 4.80% while the S&P has increased 5.31%.

In late February, tensions in the Middle East escalated following U.S. and Israeli airstrikes on Iran, triggering a series of retaliatory attacks and a broader regional conflict. The situation contributed to market volatility over the past two months, largely driven by concerns around energy supply disruptions and rising oil prices. A temporary ceasefire was reached in April, though tensions remain elevated and disruptions to regional stability continue.

In early April, the Centers for Medicare & Medicaid Services (CMS) proposed new transparency measures aimed at strengthening oversight of hospice providers amid growing concerns around fraud and improper billing within the Medicare system. The proposed measures include enhanced reporting requirements and data tracking tools designed to better identify high-risk providers.

“Hospices exist to help Americans die peaceful, dignified deaths, not to line the pockets of fraudsters,” said CMS Administrator Dr. Mehmet Oz. “These new transparency measures will make it easier for CMS and others to identify hospice providers that misuse Medicare dollars, cut off their funding, and refer them to law enforcement for criminal prosecution.”

On April 2, CMS announced the finalized CY 2027 Medicare Advantage and Part D rule, which includes updates to Star Ratings measures, enrollment processes, and prescription drug benefit policies under the Inflation Reduction Act. CMS also announced that Medicare Advantage plans are expected to receive a 2.48% average payment increase in 2027.

“Despite ongoing geopolitical uncertainty and heightened regulatory scrutiny, the underlying demand drivers for home-based care remain strong,” said Joe Lynch, Partner and Managing Director at Stoneridge Partners. If operators can continue to adapt to the evolving landscape, then we expect strategic buyers to remain active in evaluating opportunities across the sector.”

Post Acute Care Index (PAI)

During the month, Addus saw a 3.46% MoM increase in its stock price and was down 9.78% YTD. In its Q1 2026 financial results, the company announced net service revenues of $363.6 million, representing a 7.7% increase over the same period last year. Additionally, Adjusted EBITDA increased 9.7% year-over-year to $44.5 million.

“Our personal care business, which accounted for 77.3% of our revenues, was the primary driver of our growth with a 6.5% organic revenue increase over the first quarter last year,” said CEO Dirk Allison. “We benefited from higher volumes as well as additional rate support from two key states, including a 9.9% increase in Texas that was effective September 1, 2025, and a 3.9% increase from the State of Illinois that was effective beginning January 1, 2026.”

BrightSpring’s stock increased 12.58% MoM in April and is up 28.09% YTD. The company announced strong performance in its Q1 2026 financial results, with net service revenues increasing 25.6% year-over-year to $3.6 Billion. The company’s Q1 adjusted EBITDA was $190 million, a 44.8% increase compared to the same period in 2025. Additionally, on March 31, BrightSpring completed the divestiture of its Community Living Business to Sevita for $835 million.

According to CEO Jon Rousseau, “The divestiture of our Community Living business was not a decision made lightly and was guided by our priority of ensuring continued high-quality, innovative care for clients. This transition marks a thoughtful next chapter for both BrightSpring and Sevita, allowing each company to focus on its strategic direction while continuing to fulfill respective missions of helping people with complex care needs live better lives.”

In April, Enhabit’s stock price decreased 2.48% MoM, but was up 49.02% for the year. In late February, Enhabit announced that it accepted a merger agreement with Kinderhook Industries for $1.1 Billion, or $13.80 per share. The transaction is set to close in Q2 2026, after which Enhabit will become a private entity and no longer trade on the New York Stock Exchange.

“Thanks to its exceptional care teams and strong leadership, Enhabit has built a reputation for excellence across the healthcare industry,” said Matt Bubis, Managing Director at Kinderhook. “As a supportive partner, our role is to grow and foster the great work they’re already doing and to help remove barriers so their teams can stay focused on patients.”

Closing off 2025, Enhabit announced Q4 2025 net service revenue of $270.4 million, a 4.7% gain over Q4 2024, and Adjusted EBITDA of $28.0 million, an 11.6% gain over Q4 2024. Given the pending merger, the company did not hold a Q1 2026 earnings call or provide additional financial guidance for the period.

Conclusion

Despite continued geopolitical uncertainty and increased regulatory scrutiny across the healthcare sector, April reflected renewed momentum in both the broader markets and the post-acute care space. As the year progresses, buyers and operators are expected to remain active as they evaluate strategic opportunities, monitor reimbursement developments, and continue pursuing transactions already in motion.

Quote of the Month

“We are fundamentally shifting our approach to quality. This isn’t just about adjusting measures; it’s about redefining success. We are moving away from a system that incentivizes administrative box-checking and are instead laser-focused on what truly matters: the clinical outcomes and health of our beneficiaries. This is a critical first step toward a more efficient, effective, and patient-first healthcare system.”

– Chris Klomp, Director of the Center for Medicare and Chief Counselor of the U.S. Department of Health and Human Services.

Read the Full Article Here: Medicare Beneficiaries to See Simpler and More Flexible Plan Choices, Better Drug Coverage, Higher Quality and Lower Costs in 2027

Stoneridge In the News:

Selling Your Hospice Agency: Operational Metrics/CAP & Valuation Read the Full Article Here – Blog written by Partner & Managing Director Ben Bogan.

Stoneridge Partners, Joe Lynch and Tom Lillis, provided sell-side M&A advisory services to HomeCourt Home Care in their transaction with Addus HomeCare Corporation Read the Full Article Here

See It To Believe It!

The Stoneridge Partners Post-Acute Care Index is updated monthly and measures the performance of these six publicly traded post-acute care companies, all listed on the NASDAQ:

• Addus (ADUS)
• Aveanna (AVAH)
• BrightSpring (BTSG)
• Brookdale Senior Living Inc. (BKD)
• Enhabit (EHAB)
• The Pennant Group, Inc. (PNTG)

Here are the results of the Post-Acute stock prices for the past two years:

Enterprise Value (EV)

Enterprise Value (EV), aka Selling Price, as Percent of Revenue

The above calculations are based on the selling price being defined as Enterprise Value (EV), with data provided by Yahoo Finance. Enterprise value is defined as market cap plus debt, minority interest, and preferred shares, minus total cash and cash equivalents. EBITDA is calculated using a methodology that may differ from that used by a company for its reporting. (Home Health Index April 2026 | Stoneridge Partners)

Recent Transactions From Around The Country

• General Atlantic acquired TEAM Services Group
• Superior Health Holdings acquired Chant Healthcare
• Addus HomeCare acquired HomeCourt Home Care

SOLD by Stoneridge!!!

• Stoneridge Partners is proud to announce the successful sale of a Massachusetts home care agency.
• Stoneridge Partners is proud to announce the successful sale of an Indiana home care agency.
• Stoneridge Partners is proud to announce the successful sale of an Ohio home health agency.

View Stoneridge closed transactions on our Website.

Home Health Index April 2026 | Stoneridge Partners

From Joe Lynch, Publisher of “Home Health Index.” Joe can be reached at [email protected] or (239) 561-0826, and toll-free at 800-218-3944. Previous editions of this monthly newsletter can be searched for at the bottom of the home page of the Home Health Index.